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Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Myoung Soo Kim
Korean Journal of Adult Nursing 2014;26(3):253-265.
Published online: June 30, 2014

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Corresponding author: Kim, Myoung Soo Department of Nursing, Pukyong National University, 45 Yongso-ro, Nam-gu, Busan 608-737, Korea. Tel: +82-51-629-5782, Fax: +82-51-629-7906, E-mail: kanosa@pknu.ac.kr
This work was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education, Science and Technology(2011-00133252)
• Received: October 27, 2013   • Accepted: May 30, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was done to develop and evaluate a smartphone application for the medication confirmation of high-alert medications.
  • Methods
    A nonequivalent control group non-synchronized design was used for this study. Participants in the treatment group used the application for four weeks. Data were analyzed using descriptive analysisx2-test and t-test for the homogeneity of participants and a paired t-test for effectiveness in each group with the SPSS 18.0.
  • Results
    Stability of medication administration was estimated by knowledge and certainty ranged from a score of one to three. A correct answer with high certainty was coded as high stability low certainty regardless of correct answer was coded as a moderate stability and incorrect answers with high certainty were rated as low stability. There were no differences in ‘ knowledge of high alert medication “Certainty of knowledge” stability of medication administration “confidence of single checking medication” and “medication safety activities” between the treatment group and the comparison group. The treatment group reported a greater difference between pretest and post-test in ‘ certainty of medication knowledge’ (t=3.51p=.001) than the comparison group.
  • Conclusion
    Smartphone application for medication confirmation of high-alert medications will provide an important platform for reducing medication errors risk.
  • Key Words: Decision support system; Medication reconciliation; Medication error; Single checking; Patient safety
Figure 1.
Templates of developed application.
kjan-26-253f1.jpg
Figure 2.
Example of developed smartphone-based Precise Drug Dosage Calculation Application.
kjan-26-253f2.jpg
Table 1.
Homogeneity Test of Study Variables at the Baseline (N=59)
Variables (No. of items) Variables Total Exp. (n=33) Cont. (n=26) x2 or t (p)
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Age (year) 23~25 28 (47.5) 13 (39.4) 15 (46.4) 1.95 (.196)
≥26 31 (52.5) 20 (60.6) 11 (64.5)  
M±SD 26.53±3.16 27.12±3.74 25.77±2.05 1.77 (.083)
Marital status Married 5 (8.5) 3 (9.1) 2 (7.7) 0.04 (1.000)
Single 54 (91.5) 30 (90.9) 24 (92.3)  
Education College 7 (11.9) 3 (9.1) 4 (15.4) 0.55 (.688)
Bachelor 52 (88.1) 30 (90.9) 22 (84.6)  
Total nursing experience (year) ≤3 24 (40.7) 14 (42.4) 10 (38.5) 0.10 (.795)
＞3 35 (59.3) 19 (57.6) 16 (61.5)  
M±SD (month) 44.10±28.78 48.15±35.76 38.94±15.35 1.33 (.190)
Position† Charge nurse 3 (5.1) 2 (6.1) 1 (3.8) 0.15 (1.000)
Staff nurse 56 (94.9) 31 (93.9) 25 (96.2)  
Knowledge of high alert medication (20) 0.71±0.11 0.68±0.10 0.74±0.10 2.30 (.025)
Certainty of knowledge (20) 2.71±0.61 2.63±0.52 2.80±0.71 1.05 (.297)
Stability of medication administration (20) 0.91±0.63 0.77±0.56 1.09±0.69 1.97 (.054)
Confidence for single checking medication (14) 3.33±0.51 3.34±0.55 3.31±0.44 -0.23 (.817)
Medication safety activities (9) 4.20±0.42 4.13±0.43 4.29±0.38 1.55 (.127)

Exp.=experimental group; Cont.=control group.

†Fisher's exact test.

Table 2.
Changes of Study Variables between Pre-post Stages in Each Group
Variables Exp. (n=33) t (p) Cont. (n=26) t (p) Difference of Post-Pre t (p)
Pre Post Pre Post Exp. Cont.
M±SD M±SD M±SD M±SD M±SD M±SD
Knowledge of high alert medication 0.68±0.10 0.69±0.12 0.55 0.74±0.10 0.75±0.09 0.60 0.01±0.11 0.01±0.10 -0.03
    (.584)     (.555)     (.973)
Certainty of knowledge 2.63±0.52 2.96±0.47 3.51 2.80±0.71 2.97±0.64 1.27 0.32±0.53 0.17±0.68 0.97
    (.001)     (.218)     (.334)
Stability of medication administration 2.16±0.25 2.25±0.28 1.58 2.33±0.27 2.39±0.26 1.29 0.09±0.31 0.07±0.26 0.27
    (.125)     (.210)     (.785)
Confidence for single checking medication 3.34±0.55 3.39±0.54 0.60 3.31±0.44 3.37±0.42 0.58 0.04±0.41 0.05±0.46 -0.08
    (.552)     (.570)     (.938)
Medication safety activities 4.13±0.43 4.23±0.43 1.43 4.29±0.38 4.24±0.45 -0.63 0.10±0.39 -0.05±0.42 1.40
    (.163)     (.535)     (.164)
Number of daily use 7.77±±5.90              
Frequency of use 28.29±20.84              
Program satisfaction 3.00±0.95              

Exp.=experimental group; Cont.=control group.

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    Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications
    Korean J Adult Nurs. 2014;26(3):253-265.   Published online June 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.3.253
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    Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications
    Korean J Adult Nurs. 2014;26(3):253-265.   Published online June 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.3.253
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    Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications
    Image Image
    Figure 1. Templates of developed application.
    Figure 2. Example of developed smartphone-based Precise Drug Dosage Calculation Application.

    Figure 1.

    Figure 2.

    Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

    Homogeneity Test of Study Variables at the Baseline (N=59)

    Variables (No. of items) Variables Total Exp. (n=33) Cont. (n=26) x2 or t (p)
    n (%) or M±SD n (%) or M±SD n (%) or M±SD
    Age (year) 23~25 28 (47.5) 13 (39.4) 15 (46.4) 1.95 (.196)
    ≥26 31 (52.5) 20 (60.6) 11 (64.5)  
    M±SD 26.53±3.16 27.12±3.74 25.77±2.05 1.77 (.083)
    Marital status Married 5 (8.5) 3 (9.1) 2 (7.7) 0.04 (1.000)
    Single 54 (91.5) 30 (90.9) 24 (92.3)  
    Education College 7 (11.9) 3 (9.1) 4 (15.4) 0.55 (.688)
    Bachelor 52 (88.1) 30 (90.9) 22 (84.6)  
    Total nursing experience (year) ≤3 24 (40.7) 14 (42.4) 10 (38.5) 0.10 (.795)
    ＞3 35 (59.3) 19 (57.6) 16 (61.5)  
    M±SD (month) 44.10±28.78 48.15±35.76 38.94±15.35 1.33 (.190)
    Position† Charge nurse 3 (5.1) 2 (6.1) 1 (3.8) 0.15 (1.000)
    Staff nurse 56 (94.9) 31 (93.9) 25 (96.2)  
    Knowledge of high alert medication (20) 0.71±0.11 0.68±0.10 0.74±0.10 2.30 (.025)
    Certainty of knowledge (20) 2.71±0.61 2.63±0.52 2.80±0.71 1.05 (.297)
    Stability of medication administration (20) 0.91±0.63 0.77±0.56 1.09±0.69 1.97 (.054)
    Confidence for single checking medication (14) 3.33±0.51 3.34±0.55 3.31±0.44 -0.23 (.817)
    Medication safety activities (9) 4.20±0.42 4.13±0.43 4.29±0.38 1.55 (.127)

    Exp.=experimental group; Cont.=control group.

    †Fisher's exact test.

    Changes of Study Variables between Pre-post Stages in Each Group

    Variables Exp. (n=33) t (p) Cont. (n=26) t (p) Difference of Post-Pre t (p)
    Pre Post Pre Post Exp. Cont.
    M±SD M±SD M±SD M±SD M±SD M±SD
    Knowledge of high alert medication 0.68±0.10 0.69±0.12 0.55 0.74±0.10 0.75±0.09 0.60 0.01±0.11 0.01±0.10 -0.03
        (.584)     (.555)     (.973)
    Certainty of knowledge 2.63±0.52 2.96±0.47 3.51 2.80±0.71 2.97±0.64 1.27 0.32±0.53 0.17±0.68 0.97
        (.001)     (.218)     (.334)
    Stability of medication administration 2.16±0.25 2.25±0.28 1.58 2.33±0.27 2.39±0.26 1.29 0.09±0.31 0.07±0.26 0.27
        (.125)     (.210)     (.785)
    Confidence for single checking medication 3.34±0.55 3.39±0.54 0.60 3.31±0.44 3.37±0.42 0.58 0.04±0.41 0.05±0.46 -0.08
        (.552)     (.570)     (.938)
    Medication safety activities 4.13±0.43 4.23±0.43 1.43 4.29±0.38 4.24±0.45 -0.63 0.10±0.39 -0.05±0.42 1.40
        (.163)     (.535)     (.164)
    Number of daily use 7.77±±5.90              
    Frequency of use 28.29±20.84              
    Program satisfaction 3.00±0.95              

    Exp.=experimental group; Cont.=control group.
    Table 1. Homogeneity Test of Study Variables at the Baseline (N=59)

    Exp.=experimental group; Cont.=control group.

    Fisher's exact test.

    Table 2. Changes of Study Variables between Pre-post Stages in Each Group

    Exp.=experimental group; Cont.=control group.

    Table 1.

    Table 2.

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